Immuno-biological substance designed to produce specific

protection against a given disease.

Stimulates the production of protective antibodies and
other immune mechanisms.

Types;
Live vaccines
Inactivated or killed vaccines
Toxoids
Cellular fractions
Combinations
Prepared from live organisms. (Generally
attenuated)
Passed repeatedly in lab and have lost capacity to
induce full blown disease.
Contraindicated in:
Immune deficiency diseases
Suppressed immune response e.g. leukemia,
lymphomas, chemotherapy etc.

Organisms killed by heat or chemicals.
Usually administered by subcutaneous or
intramuscular route.
Usually require a primary series of doses and then
boosters.
Certain organisms produce exotoxins e.g. diphtheria,
tetanus.
Exotoxins are detoxicated and used in vaccines.
Act against the toxic effects of toxins in the disease.
Highly safe and highly efficacious.
VACCINES
BACTERIAL
BCG, Typhoid
VIRAL
Oral Polio, Yellow
Fever, Measles, Rubella,
Mumps, Influenza
RICKETTSIAL
Epidemic typhus
BACTERIAL
Typhoid, Cholera,
Pertussis, Plague,
Meningitis
VIRAL
Rabies, Polio,
Influenza, Hepatitis B,
Japanese Encephalitis

BACTERIAL
Diphtheria, Tetanus
LIVE ATTENUATED INACTIVATED OR KILLED TOXOIDS
NATIONAL IMMUNIZATION SCHEDULE
At birth (institutional deliveries)
At 6 weeks

At 10 weeks
At 14 weeks
At 9 months
At 16-24 months
At 5 years
At 10 & 16 years
Pregnant women
Early in pregnancy
1 month after TT-1
BCG & OPV-0 dose
BCG(if not given at birth)
DPT-1, OPV-1, HEP B-1
DPT-2, OPV-2, HEP B-2
DPT-3, OPV-3, HEP B-3
Measles
DPT & OPV
DT
TT

TT-1 or booster
TT-2
Nature: Live attenuated viral vaccine
Type: Trivalent (type I, II, III)
Composition per dose:
over 3,00,000 TCID 50 of type I poliovirus
over 1,00,000 TCID 50 of type II poliovirus
over 3,00,000 TCID 50 of type III poliovirus
Dose: 2 drops
Route: oral
Schedule: at birth, 6, 10 & 14 weeks & then booster at 18 months
Indications: all newborns as per National Immunization schedule.
Advantages: cheap, given orally, prevents both paralysis & intestinal
reinfection, it can be used in controlling epidemics.


* TCID Tissue culture infective dose

Nature: Live attenuated bacterial vaccine
Composition: Danish 1331 strain
Diluent used is normal saline
0.1 ml contains 0.1 mg of this strain
Dose: 0.1 ml
Children < 4 wks are given 0.05ml
Route: I/D; tuberculin syringe (Omega microstat syringe is used)
Schedule: at birth or at 6 weeks.
It can be given up to 1 year.
Aim: To induce benign, artificial primary infection which provides resistance to
possible subsequent infection by virulent tubercle bacteria.
Phenomenon after vaccination:
Papule(2-3 wks) increases in dia to reach size of 4-8mm(5wk) shallow
ulcer heals to form scar(6-12wk)
Indication: all newborns as per National Immunization schedule.
Contraindication: eczema, infectious dermatosis, symptomatic HIV
Complications: prolonged severe ulceration, suppurative lymphadenitis,
osteomyelitis, disseminated BCG
Nature: combined vaccine
Composition (Kasauli):
Diphtheria toxoid- 30 Lf
Tetanus toxoid: 10 Lf
B. pertussis: >4IU
Al phosphate: 3 mg
Thiomersal BP: 0.01%
Dose: 0.5 ml
Route: Deep I/M
Schedule: 6, 10 & 14 weeks; booster at 1&1/2 year.
Indication: all newborns as per NIS
Contraindications: serious illness, severe reaction to previous dose.
Adverse reactions: hypersensitivity reactions, convulsions, neurological
reactions, rise in temperature.
* Lf limit of flocculation
Nature: recombinant DNA vaccine
Composition: 0.5 ml contains;
10 microgram of Hbs Ag
0.25mg of Al(OH)3
0.25 mg of thiomersal
Dose: 0.5ml
Site: anterolateral aspect of thigh in children < 1 year &
deltoid in > 1 year of age
Route: I/M
Schedule: Rapid immunity- 0,1,2
Slow- 0,1,6
Booster(rapid)-12 months,18 months
Booster(slow)-5 years
Indications: health professionals, I/V drug users, travellers
to endemic areas, sexually active, newborns as per NIS.

Nature: split virus vaccine, surface antigens included.
Composition: lyophilized 0.5 ml= 10 microgram of
capsular polysaccharide.
Dose: 0.5ml
Route: I/M
Site: deltoid, anterolateral aspect of thigh
Schedule: 6, 10, 14 week & booster with DPT
Indication: 6 weeks-6 years
Contraindications: known hypersensitivity, pregnancy
& lactation
Adverse effect: fever, restlessness
Nature: Live attenuated vaccine; tissue culture vaccine
Composition : 1000 TCD of Edmonston Zagreb strain.
Dose: 0.5ml
Site: arm
Route: S/C
Schedule: 9 months of age
Indications: all infants as per NIS
Contraindications: Pregnancy, decreased cell mediated
immunity, use of corticosteroids or other
immunosuppressants
Adverse effects: toxic shock syndrome


Nature: Live attenuated vaccine;
measles
mumps
rubella
Composition:
Measles- 1000 CCID 50
Mumps- 5000 CCID 50
Rubella- 1000 CCID 50
Diluent: distilled water
Dose: 0.5 ml
Route: S/C
Site: Deltoid
Schedule: 12 months-12 years -1 dose
adults 2 doses 4 weeks apart
Indications: 12months-12years, decreased cell mediated immunity
Adverse effects: febrile convulsions, mild fever & restlessness

* CCID Cell culture infective dose
Nature: Phenol inactivated Vi Ag of Salmonella typhi
Route: I/M
Composition: 0.5ml=25 microgram of capsular
polysaccharide
Dose 0.5ml
Schedule: > 2 year; every 3 years
Indications: Travellers, immigrants to endemic
countries, armed personnel
Contraindications: hypersensitivity
Adverse effects: fever
Nature: Inactivated hepatitis A virus
Dose: 0.5ml (1-18 years), 1ml (>19 years)
Route: I/M
Site: Deltoid in adults
Anterolateral aspect of thigh in children
Schedule: 2 doses with 2
nd
dose given 6-12 months
later
Indications: Travelers, hostellers, armed forces, HBV
patient
Contraindication: known hypersensitivity
Adverse effect: myalgia, arthralgia
Nature: Live attenuated strain (oka) of VZV.
Composition: 0.5 ml= not less than 2000

PFU of VZV
Schedule: 1-12 year only 1 dose
>12 year 2 doses 6 weeks apart
Route: S/C
Site: Deltoid
Indication: household contact, health care workers
Contraindication: Pregnancy, known hypersensitivity
Adverse effects: headache, fever, fatigue